Study Examines Use of Neoadjuvant Chemotherapy in Elderly Patients With Breast Cancer

Increasing utilization of neoadjuvant chemotherapy (NAC) among patients age 65 years and older with triple negative breast cancer (TNBC) or HER2+ breast cancer has led to no increased risk of chemotherapy-related complications or hospitalizations, according to a poster presentation at the Mayo Clinic at the virtual 38th Annual Miami Breast Cancer Conference® (MBCC). The study also found that the wider use of NAC in elderly patients is independent of patient age and cancer stage as predictive factors.

The investigators performed a retrospective review of 215 patients age 65 years and older with TNBC or HER2+ breast cancer who underwent mastectomy from 2005 to 2020 at a single institution. According to the data presented at MBCC, there was a significant increase in the proportion of elderly patients receiving NAC, rising from 6% during the 2005–2010 period to 50.7% in 2016–2020 (P < .001), but no significant difference in the rate of hospitalizations or chemotherapy dose reductions in patients receiving NAC compared to those who received only adjuvant chemotherapy.

The study also found changes in the types of chemotherapeutic agents used for neoadjuvant and adjuvant chemotherapy over this period, with anthracycline usage significantly decreasing from 2005 to 2020. In the 2005–2010 period, anthracycline usage was at 18.6% (P < .0001) compared to 0.0% during 2016–2020.

Researchers also conducted univariate and multivariate analyses to evaluate rates and predictive factors of NAC use in the elderly. Multivariate analysis showed that this increase in patients receiving NAC was independent of patient age and tumor stage at the time of evaluation.

REFERENCE

Sami Abujbarah, BA, Heidi E Kosiorek, MS, Jacob B Hammond, MD, et al. Neoadjuvant chemotherapy use in elderly breast cancer patients. Poster presented at: Miami Breast Cancer Conference; virtual: March 4, 2021.